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The Case for a DHHS operated Forensic Hospital

The State of Maine lacks the capacity and leadership to serve the most ill among us, continuing to take giant steps backwards in criminalizing serious mental illness. Today, Judge Murphy in Kennebec County heard the case of Anthony Reed charged with the assault of a Riverview staff person that occurred in 2014. The assault happened after Mr. Reed had been found Not Criminally Responsible (NCR) for a previous assault at Riverview but was placed at Kennebec County Jail when Riverview did not feel they had the capacity to serve Mr. Reed’s needs. Anthony Reed has serious and persistent mental illness with a history of assaultive behavior. Due to the severity of Mr. Reed’s illness the Commissioner of the Department of Health and Human Services (DHHS) determined that only a jail setting could manage his violent outbursts. This placement violated Maine State law. Equally as important, it criminalized Mr. Reed’s illness.

At the hearing today, the question at hand was how to proceed with this new change of assault, as Mr. Reed is still operating under a court order to receive treatment as an individual classified as NCR. Judge Murphy asked many questions of the DHHS as they presented a plan to send Mr. Reed to a facility in South Carolina that caters to hard-to-serve criminal justice and mental health populations.

Correct Care Recovery Solutions, operating the Columbia Regional Care Center, is the only private detention healthcare facility in the country. It holds accreditation from the National Commission on Correctional Healthcare (NCCHC). The 374-bed facility offers sub-acute, skilled, intermediate and hospice care for certain conditions, such as AIDS, cancer, cardiac disease and mental health. The website for the center states that it “was designed to provide detention healthcare.” The center serves individuals determined to be NCR and Incompetent to Stand Trial (IST) from the State of South Carolina, holds Joint Commission Accreditation and is operated in partnership with the South Carolina Department of Mental Health.

There were several important policy issues that were obvious today during Anthony’s 3-hour hearing:

There is a clear need to appoint a guardian in any case where a person has been found NCR and new charges are filed. Anthony was not equip to advocate for his own best interests and he became increasingly confused as the conversation circled for hours. His lawyer’s job was to address the criminal charges, while a guardian’s job would be to act on behalf of Anthony. As the court assigns guardians in child welfare cases, they should also be assigned when a person identified as NCR has a new charge filed.

Kennebec County spent upwards of $57 million dollars to build a new court house, yet a person with a serious and persistent mental illness is brought into a court room, shackled and left sitting there for hours with two deputies staring at him. There needs to be a more appropriate space to hold a person with a mental illness during preparation for court hearings to begin.

The State of Maine has to create a program that is small in size and able to serve individuals, such as Anthony Reed. DHHS violated the law in placing Anthony at Kennebec County Jail after his first NCR finding. In court, the Assistant Attorney General stated that the Department of Corrections would not take Anthony back to Warren after the hearing today if he was again identified as NCR. They were not willing to violate state law again. The statement was made in open court that taking a person classified as NCR into the Maine State Prison was not legally appropriate, yet Jay Harper testified to Judge Murphy that he had no control over what unit (correctional or mental health) Anthony would be assigned to at the facility in South Carolina. Through this process, Maine would not violate the law by holding a person found NCR in a correctional setting, yet DHHS would be willing to transfer someone out-of-state, knowing that they would likely be placed in a correctional unit. Responding to the State’s request, Judge Murphy did hold the case over until November 30th, allowing DHHS time to agree upon a contract with Columbia Regional Care Center and arrange transport from Maine to South Carolina. The State of Maine will spend thousands of dollars supporting a for-profit correctional facility rather than developing the capacity to serve Mainers with serious mental illness right here at home.

The real loser in this whole process has been Anthony Reed, who during a court break asked his father questions like, “How’s my brother?”, “Are grama and grampa still alive?” and “How’s mom?” Looking for a connection back to his humanity, Anthony’s focus was on being able to attend groups and live a life outside of a small jail cell. He has been shackled anytime he has left his cell for over a year. Anthony has delusions, including auditory, tactile and visual.

He is a 40-year-old man with many challenges, but he is a person living with a serious mental illness, not a criminal. He deserves far better than the State of Maine has provided and, under their breath even members of LePage’s administration will comment that no one has done right by Anthony. A path to recovery has been hard for Mr. Reed to find, but it has been made so much harder by the failures of a system intended to guide him.